Season Manuel

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11026619 Issued in FL

Practice address

4400 E Highway 20 Ste 313
Niceville, FL 32578-7700

Phone

(850) 797-2598

Fax

(850) 807-5127

NPI assigned

Jun 2, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bluewater Primary Care, Inc

  • Primary Care Nurse Practitioner
  • Niceville, FL
  • NPI 1831936962

  Single Specialty

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1801580931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24555 US HIGHWAY 331 S UNIT E306",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324596199",
            "telephone_number": "901-334-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 313",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-797-2598",
            "fax_number": "850-807-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "SEASON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11026619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Keefe, MD Pediatrics, LLC
• Emily Makela
• Joy Makela, LMHC, LSP, LPC, NCC
• Austin Mallett
• Andrea Maruzs Mallory, LMHC
• Alexandra Marchand
• Catherine Joan Marion, IMH
• Sarah Lynn Marion, LMHC, LMFT
• Mark E. Schroeder M.D.PA
• Mark S Harber MD LLC

• Psychiatric/Mental Health Nurse Practitioner in Niceville, FL
• Providers in Niceville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.